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Healthcare Models Wiki
Welcome to Group 3 - Team Based Care Models MSNV602 - Nursing Theory Created by Supreet Kaur, Michael Mariano, & Jenessia Rodriguez The purpose of this wiki page is to provide you with an informational overview on team-based Healthcare Models and how they benefit practice. The two focused on this wiki are: Chronic Care Model Patient Centered Medical Home Definition Chronic Care Model In 1996, the Chronic Care Model (CCM) was proposed as an alternative healthcare delivery system to improve illness-related outcomes (Ercolano et al., 2016). The CCM is a theoretical framework widely used to develop and describe initiatives to improve care specifically for those with Long term conditions (LTCs) (Barker, de Lusignan, Baguley, & Gagne, 2014). Patient Centered Medical Home Improve health care in America by transforming how primary care is organized and delivered. There are five functions and attributes: # Comprehensive care: accountable for meeting the large majority of each patient’s physical and mental health care needs, including prevention and wellness, acute care, and chronic care. # Patient-centered: provides health care that is relationship-based with an orientation toward the whole person. Partnering with patients and their families requires understanding and respecting each patient’s unique needs, culture, values and preferences. The medical home practice actively supports patients in learning to manage and organize their own care at the level the patient chooses. # Coordinated care: coordinated care across all elements of the broader health care system, including specialty care, hospitals, home health care, and community services and supports. This is particularly critical during transitions between sites of care, such as when a patient is discharged from the hospital. The practices also excel at building clear and open communication among patients and families, medical home, and members of the broader care team. # Accessible Services: They deliver accessible services with shorter wait time for urgent needs, enhanced in-person hours, around-the-clock phone or electronic access to a member of the care team, and alternative methods of communication such as email or phone. The medical home practice is responsive to patients’ preferences regarding access. # Quality and safety: they are committed to quality and quality improvement by ongoing engagement in activities such as using evidence-based medicine and clinical decision-support tools to guide shared decision making with patients and families, engaging in performance measurement and improvement, measuring and responding to patient experiences and patient satisfaction, and practicing population health management. Advantages Chronic Care Model Implementation of the CCM is associated with improved outcomes (Barker et al., 2014). This model suited well with chronic conditions such as asthma, diabetes mellitus, and heart failure. Whilst some elements of the model such as self-management support and delivery system design have been shown to have a positive effect on outcomes such as physiological measures of disease, service use, and adherence to treatment in chronic conditions outcomes (Barker et al., 2014). Patient Center Medical Home * Trains both new and experienced practice facilitators in the knowledge and skills needed to support improvement in primary care practices. * Allows patients to be more involved in their care and determine their needs. * Improved efficiency and lower practice costs * Enhanced reimbursement support * Additional recognition * Participation in other value-based care Disadvantages Chronic Care Model However, it has been suggested that the scope of the CCM maybe too limited and that population health and prevention should be added to the model to create an ‘extended’ chronic care model (Barr et al., 2003) or that more emphasis should be placed on the policy environment (Bodenheimer, 2003; Epping-Jordan et al., 2004). However, these extended versions of the CCM share the six core elements in common with the standard model and there is no evidence to suggest that the additions to the model convey additional benefit in terms of process or clinical outcome (Barker et al., 2014). Patient Centered Medical Home * Patients need to be more educated and engaged in their own care * Financial burden * Accreditation takes dedication, time, and teamwork Implementing a healthcare model Chronic Care Model One example of implementing the chronic care model in diabetes management, the results suggested Implementing the CCM became feasible despite serious challenges and two groups of ready and active team and active patients were developed. The study showed that one important lost link of diabetes management is underestimating the nurses’ capabilities in the management of this disease (Molayaghobi et al., 2019). Patient Centered Medical Home The Primary Care Practice Facilitation (PCPF) Curriculum is designed to support the development of a PCPF workforce prepared to help transform and revitalize primary care by supporting widespread adoption of new models of care delivery and the use of continuous quality improvement to improve health care outcomes. This PCPF curriculum can serve to train both new and experienced practice facilitators in the knowledge and skills needed to support meaningful improvement in primary care practices. This curriculum builds on and expands earlier training resources for PCPF developed by the Agency for Healthcare Research and Quality (AHRQ). Some of the curriculum modules are new, and others are updated versions of material available in the Practice Facilitation Handbook. The objective of this curriculum is to provide a more comprehensive practice facilitator training curriculum. In conjunction with other practice facilitation training resources available from AHRQ, this curriculum can be used to develop a comprehensive PCPF training program. References Barker, F., de Lusignan, S., Baguley, D., & Gagne, J.-P. (2014). An evaluation of audiology service improvement documentation in England using the chronic care model and content analysis. International Journal of Audiology, 53(6), 377–382. https://doi.org/10.3109/14992027.2013.860242. Bresnick, J.(2014). Benefits and Challenges of the Patient-Centered Medical Home. Retrieved May 23, 2019 from https://healthitanalytics.com/news/benefits-challenges-patient-centered-medical-home/. Defining the PCMH.(n.d.). Retrieved May 22, 2019, from https://pcmh.ahrq.gov/page/defining-pcmh. Ercolano, E., Grant, M., McCorkle, R., Tallman, N. J., Cobb, M. D., Wendel, C., & Krouse, R. (2016). Applying the Chronic Care Model to Support Ostomy Self-Management: Implications for Oncology Nursing Practice. Clinical Journal of Oncology Nursing, 20(3), 269–274. https://doi.org/10.1188/16.CJON.20-03AP. Molayaghobi, N., Abazari, P., Taleghani, F., Iraj, B., Etesampour, A., Zarei, A., . . . Abasi, F. (2019). Overcoming challenges of implementing chronic care model in diabetes management: An action research approach.'' International Journal of Preventive Medicine, 10''(1), 13. doi:http://dx.doi.org/10.4103/ijpvm.IJPVM_485_18. Patient-Centered Medical Home (PCMH). Retrieved May 25, 2019, from https://waikikihc.org/patients/pcmh-2/. What are the benefits of PCMH? (2017, June 28). Retrieved May 23, 2019, from https://www.practicefusion.com/pcmh/what-are-the-benefits-of-pcmh/. Chronic Care Model and Patient Centered Care Model Category:Browse